An Interpretative Phenomenological Analysis of the Experience of Self-Disgust in people with Functional/dissociative Seizures

Objective
Psychological distress and trauma is common among people with functional/dissociative seizures (pwFDS). Self-disgust, a maladaptive internalisation of disgust, is implicated in many mental and physical health conditions. It has been explored in various conditions, but has yet to be understood in FDS. This study therefore aimed to gain an understanding of the experience of self-disgust in pwFDS.
Methods
This study employed a qualitative design with interpretative phenomenological analysis (IPA) methodology. Following initial screening for self-disgust, purposive sampling was used to recruit eight eligible participants to undergo semi-structured interviews about their experiences of self-disgust.
Results
In the larger sample (n= 108), 85.18% of participants reported high levels (>31) of self-disgust. IPA produced four themes ‘understanding the origin of self-disgust as based in rejection’, ‘experiencing self-disgust as intense and inescapable’, ‘understanding the relationship between self-disgust and FDS’ and ‘suppression and seclusion- attempting to cope with self-disgust’.
Conclusions
Self-disgust may be relevant to a subpopulation of pwFDS. A bi-directional relationship between self-disgust and FDS exists that likely arises from internalisation of traumatic experiences. Participants’ attempts to reduce self-disgust provided short-term relief.
Practitioner Points
• Practitioners should be aware of self-disgust during assessments as it may be important to inform psychological interventions.
• Existing psychological interventions may be helpful to support pwFDS’ experience of self-disgust.
• There is a need for specific FDS training among healthcare, and other, professions to increase awareness and reduce the stigma associated with the condition.